|
HC PRESSURE WIRE
|
Facility
|
OP
|
$2,158.09
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$863.24 |
| Max. Negotiated Rate |
$2,158.09 |
| Rate for Payer: Aetna Commercial |
$1,942.28
|
| Rate for Payer: ASR ASR |
$2,093.35
|
| Rate for Payer: BCBS Complete |
$863.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.17
|
| Rate for Payer: BCN Commercial |
$1,673.17
|
| Rate for Payer: Cash Price |
$1,726.47
|
| Rate for Payer: Cofinity Commercial |
$2,028.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,726.47
|
| Rate for Payer: Healthscope Commercial |
$2,158.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,093.35
|
| Rate for Payer: Mclaren Commercial |
$1,942.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,834.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,963.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,532.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,899.12
|
|
|
HC PRESSURE WIRE
|
Facility
|
IP
|
$2,158.09
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,510.66 |
| Max. Negotiated Rate |
$2,158.09 |
| Rate for Payer: Aetna Commercial |
$1,942.28
|
| Rate for Payer: ASR ASR |
$2,093.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.17
|
| Rate for Payer: BCN Commercial |
$1,673.17
|
| Rate for Payer: Cash Price |
$1,726.47
|
| Rate for Payer: Cofinity Commercial |
$2,028.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,726.47
|
| Rate for Payer: Healthscope Commercial |
$2,158.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,093.35
|
| Rate for Payer: Mclaren Commercial |
$1,942.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,834.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,510.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,899.12
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.40 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: ASR ASR |
$98.94
|
| Rate for Payer: BCBS Trust/PPO |
$79.08
|
| Rate for Payer: BCN Commercial |
$79.08
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$95.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$102.00
|
| Rate for Payer: Healthscope Whirlpool |
$98.94
|
| Rate for Payer: Mclaren Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.76
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: ASR ASR |
$98.94
|
| Rate for Payer: BCBS Complete |
$35.69
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$79.08
|
| Rate for Payer: BCN Commercial |
$79.08
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$95.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$102.00
|
| Rate for Payer: Healthscope Whirlpool |
$98.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$62.14
|
| Rate for Payer: Mclaren Commercial |
$91.80
|
| Rate for Payer: Mclaren Medicaid |
$33.99
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Medicaid |
$35.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicaid |
$33.99
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.82
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$72.42
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.76
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: VA VA |
$62.14
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
IP
|
$50.49
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.34 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$45.44
|
| Rate for Payer: ASR ASR |
$48.98
|
| Rate for Payer: BCBS Trust/PPO |
$39.14
|
| Rate for Payer: BCN Commercial |
$39.14
|
| Rate for Payer: Cash Price |
$40.39
|
| Rate for Payer: Cofinity Commercial |
$47.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.39
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Healthscope Whirlpool |
$48.98
|
| Rate for Payer: Mclaren Commercial |
$45.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.43
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
OP
|
$50.49
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$45.44
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: ASR ASR |
$48.98
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$39.14
|
| Rate for Payer: BCN Commercial |
$39.14
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$40.39
|
| Rate for Payer: Cash Price |
$40.39
|
| Rate for Payer: Cofinity Commercial |
$47.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Healthscope Whirlpool |
$48.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.60
|
| Rate for Payer: Mclaren Commercial |
$45.44
|
| Rate for Payer: Mclaren Medicaid |
$6.89
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.92
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Medicaid |
$6.89
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.95
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$35.85
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.43
|
| Rate for Payer: UHC Medicare Advantage |
$12.98
|
| Rate for Payer: VA VA |
$12.60
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$144.90 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna Commercial |
$186.30
|
| Rate for Payer: ASR ASR |
$200.79
|
| Rate for Payer: BCBS Trust/PPO |
$160.49
|
| Rate for Payer: BCN Commercial |
$160.49
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$194.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.60
|
| Rate for Payer: Healthscope Commercial |
$207.00
|
| Rate for Payer: Healthscope Whirlpool |
$200.79
|
| Rate for Payer: Mclaren Commercial |
$186.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$182.16
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$292.46 |
| Rate for Payer: Aetna Commercial |
$186.30
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: ASR ASR |
$200.79
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$160.49
|
| Rate for Payer: BCN Commercial |
$160.49
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$194.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$207.00
|
| Rate for Payer: Healthscope Whirlpool |
$200.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.27
|
| Rate for Payer: Mclaren Commercial |
$186.30
|
| Rate for Payer: Mclaren Medicaid |
$9.45
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Medicaid |
$9.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.95
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicaid |
$9.45
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$292.46
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$233.97
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$182.16
|
| Rate for Payer: UHC Medicare Advantage |
$17.79
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
OP
|
$26.52
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.37 |
| Max. Negotiated Rate |
$79.53 |
| Rate for Payer: Aetna Commercial |
$23.87
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: ASR ASR |
$25.72
|
| Rate for Payer: BCBS Complete |
$8.79
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$20.56
|
| Rate for Payer: BCN Commercial |
$20.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$26.52
|
| Rate for Payer: Healthscope Whirlpool |
$25.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.30
|
| Rate for Payer: Mclaren Commercial |
$23.87
|
| Rate for Payer: Mclaren Medicaid |
$8.37
|
| Rate for Payer: Mclaren Medicare |
$15.30
|
| Rate for Payer: Meridian Medicaid |
$8.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.54
|
| Rate for Payer: PACE Medicare |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$16.83
|
| Rate for Payer: PHP Medicaid |
$8.37
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.53
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow Network |
$63.62
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.34
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
IP
|
$26.52
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.56 |
| Max. Negotiated Rate |
$26.52 |
| Rate for Payer: Aetna Commercial |
$23.87
|
| Rate for Payer: ASR ASR |
$25.72
|
| Rate for Payer: BCBS Trust/PPO |
$20.56
|
| Rate for Payer: BCN Commercial |
$20.56
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$26.52
|
| Rate for Payer: Healthscope Whirlpool |
$25.72
|
| Rate for Payer: Mclaren Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.34
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
OP
|
$37.74
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.07 |
| Max. Negotiated Rate |
$92.35 |
| Rate for Payer: Aetna Commercial |
$33.97
|
| Rate for Payer: Aetna Medicare |
$16.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.74
|
| Rate for Payer: ASR ASR |
$36.61
|
| Rate for Payer: BCBS Complete |
$9.53
|
| Rate for Payer: BCBS MAPPO |
$16.59
|
| Rate for Payer: BCBS Trust/PPO |
$29.26
|
| Rate for Payer: BCN Commercial |
$29.26
|
| Rate for Payer: BCN Medicare Advantage |
$16.59
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.59
|
| Rate for Payer: Healthscope Commercial |
$37.74
|
| Rate for Payer: Healthscope Whirlpool |
$36.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.59
|
| Rate for Payer: Mclaren Commercial |
$33.97
|
| Rate for Payer: Mclaren Medicaid |
$9.07
|
| Rate for Payer: Mclaren Medicare |
$16.59
|
| Rate for Payer: Meridian Medicaid |
$9.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.08
|
| Rate for Payer: PACE Medicare |
$15.76
|
| Rate for Payer: PACE SWMI |
$16.59
|
| Rate for Payer: PHP Commercial |
$18.25
|
| Rate for Payer: PHP Medicaid |
$9.07
|
| Rate for Payer: PHP Medicare Advantage |
$16.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.35
|
| Rate for Payer: Priority Health Medicare |
$16.59
|
| Rate for Payer: Priority Health Narrow Network |
$73.88
|
| Rate for Payer: Railroad Medicare Medicare |
$16.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.21
|
| Rate for Payer: UHC Medicare Advantage |
$17.09
|
| Rate for Payer: VA VA |
$16.59
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
IP
|
$37.74
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.42 |
| Max. Negotiated Rate |
$37.74 |
| Rate for Payer: Aetna Commercial |
$33.97
|
| Rate for Payer: ASR ASR |
$36.61
|
| Rate for Payer: BCBS Trust/PPO |
$29.26
|
| Rate for Payer: BCN Commercial |
$29.26
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$37.74
|
| Rate for Payer: Healthscope Whirlpool |
$36.61
|
| Rate for Payer: Mclaren Commercial |
$33.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.21
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$248.00
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$43.34 |
| Max. Negotiated Rate |
$248.00 |
| Rate for Payer: Aetna Commercial |
$223.20
|
| Rate for Payer: Aetna Medicare |
$79.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.04
|
| Rate for Payer: ASR ASR |
$240.56
|
| Rate for Payer: BCBS Complete |
$45.51
|
| Rate for Payer: BCBS MAPPO |
$79.23
|
| Rate for Payer: BCBS Trust/PPO |
$192.27
|
| Rate for Payer: BCN Commercial |
$192.27
|
| Rate for Payer: BCN Medicare Advantage |
$79.23
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$233.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.23
|
| Rate for Payer: Healthscope Commercial |
$248.00
|
| Rate for Payer: Healthscope Whirlpool |
$240.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$79.23
|
| Rate for Payer: Mclaren Commercial |
$223.20
|
| Rate for Payer: Mclaren Medicaid |
$43.34
|
| Rate for Payer: Mclaren Medicare |
$79.23
|
| Rate for Payer: Meridian Medicaid |
$45.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.80
|
| Rate for Payer: PACE Medicare |
$75.27
|
| Rate for Payer: PACE SWMI |
$79.23
|
| Rate for Payer: PHP Commercial |
$87.15
|
| Rate for Payer: PHP Medicaid |
$43.34
|
| Rate for Payer: PHP Medicare Advantage |
$79.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$225.68
|
| Rate for Payer: Priority Health Medicare |
$79.23
|
| Rate for Payer: Priority Health Narrow Network |
$176.08
|
| Rate for Payer: Railroad Medicare Medicare |
$79.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.24
|
| Rate for Payer: UHC Medicare Advantage |
$81.61
|
| Rate for Payer: VA VA |
$79.23
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$248.00
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$248.00 |
| Rate for Payer: Aetna Commercial |
$223.20
|
| Rate for Payer: ASR ASR |
$240.56
|
| Rate for Payer: BCBS Trust/PPO |
$192.27
|
| Rate for Payer: BCN Commercial |
$192.27
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$233.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.40
|
| Rate for Payer: Healthscope Commercial |
$248.00
|
| Rate for Payer: Healthscope Whirlpool |
$240.56
|
| Rate for Payer: Mclaren Commercial |
$223.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.24
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$190.00
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$133.00 |
| Max. Negotiated Rate |
$190.00 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: ASR ASR |
$184.30
|
| Rate for Payer: BCBS Trust/PPO |
$147.31
|
| Rate for Payer: BCN Commercial |
$147.31
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$178.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Healthscope Commercial |
$190.00
|
| Rate for Payer: Healthscope Whirlpool |
$184.30
|
| Rate for Payer: Mclaren Commercial |
$171.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.20
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$190.00
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$76.00 |
| Max. Negotiated Rate |
$190.00 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: ASR ASR |
$184.30
|
| Rate for Payer: BCBS Complete |
$76.00
|
| Rate for Payer: BCBS Trust/PPO |
$147.31
|
| Rate for Payer: BCN Commercial |
$147.31
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$178.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Healthscope Commercial |
$190.00
|
| Rate for Payer: Healthscope Whirlpool |
$184.30
|
| Rate for Payer: Mclaren Commercial |
$171.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.90
|
| Rate for Payer: Priority Health Narrow Network |
$134.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$167.20
|
|
|
HC PRO BNP
|
Facility
|
IP
|
$151.20
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$105.84 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna Commercial |
$136.08
|
| Rate for Payer: ASR ASR |
$146.66
|
| Rate for Payer: BCBS Trust/PPO |
$117.23
|
| Rate for Payer: BCN Commercial |
$117.23
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cofinity Commercial |
$142.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.96
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Healthscope Whirlpool |
$146.66
|
| Rate for Payer: Mclaren Commercial |
$136.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.06
|
|
|
HC PRO BNP
|
Facility
|
OP
|
$151.20
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.48 |
| Max. Negotiated Rate |
$199.07 |
| Rate for Payer: Aetna Commercial |
$136.08
|
| Rate for Payer: Aetna Medicare |
$39.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: ASR ASR |
$146.66
|
| Rate for Payer: BCBS Complete |
$22.55
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$117.23
|
| Rate for Payer: BCN Commercial |
$117.23
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cofinity Commercial |
$142.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Healthscope Whirlpool |
$146.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$39.26
|
| Rate for Payer: Mclaren Commercial |
$136.08
|
| Rate for Payer: Mclaren Medicaid |
$21.48
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Medicaid |
$22.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.52
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$43.19
|
| Rate for Payer: PHP Medicaid |
$21.48
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.07
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health Narrow Network |
$159.26
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$133.06
|
| Rate for Payer: UHC Medicare Advantage |
$40.44
|
| Rate for Payer: VA VA |
$39.26
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.90 |
| Max. Negotiated Rate |
$67.00 |
| Rate for Payer: Aetna Commercial |
$60.30
|
| Rate for Payer: ASR ASR |
$64.99
|
| Rate for Payer: BCBS Trust/PPO |
$51.95
|
| Rate for Payer: BCN Commercial |
$51.95
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$62.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.60
|
| Rate for Payer: Healthscope Commercial |
$67.00
|
| Rate for Payer: Healthscope Whirlpool |
$64.99
|
| Rate for Payer: Mclaren Commercial |
$60.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.96
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$67.00 |
| Rate for Payer: Aetna Commercial |
$60.30
|
| Rate for Payer: Aetna Medicare |
$16.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.94
|
| Rate for Payer: ASR ASR |
$64.99
|
| Rate for Payer: BCBS Complete |
$9.62
|
| Rate for Payer: BCBS MAPPO |
$16.75
|
| Rate for Payer: BCBS Trust/PPO |
$51.95
|
| Rate for Payer: BCN Commercial |
$51.95
|
| Rate for Payer: BCN Medicare Advantage |
$16.75
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$62.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.75
|
| Rate for Payer: Healthscope Commercial |
$67.00
|
| Rate for Payer: Healthscope Whirlpool |
$64.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.75
|
| Rate for Payer: Mclaren Commercial |
$60.30
|
| Rate for Payer: Mclaren Medicaid |
$9.16
|
| Rate for Payer: Mclaren Medicare |
$16.75
|
| Rate for Payer: Meridian Medicaid |
$9.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.95
|
| Rate for Payer: PACE Medicare |
$15.91
|
| Rate for Payer: PACE SWMI |
$16.75
|
| Rate for Payer: PHP Commercial |
$18.42
|
| Rate for Payer: PHP Medicaid |
$9.16
|
| Rate for Payer: PHP Medicare Advantage |
$16.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.97
|
| Rate for Payer: Priority Health Medicare |
$16.75
|
| Rate for Payer: Priority Health Narrow Network |
$47.57
|
| Rate for Payer: Railroad Medicare Medicare |
$16.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.96
|
| Rate for Payer: UHC Medicare Advantage |
$17.25
|
| Rate for Payer: VA VA |
$16.75
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
IP
|
$7,278.36
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,094.85 |
| Max. Negotiated Rate |
$7,278.36 |
| Rate for Payer: Aetna Commercial |
$6,550.52
|
| Rate for Payer: ASR ASR |
$7,060.01
|
| Rate for Payer: BCBS Trust/PPO |
$5,642.91
|
| Rate for Payer: BCN Commercial |
$5,642.91
|
| Rate for Payer: Cash Price |
$5,822.69
|
| Rate for Payer: Cofinity Commercial |
$6,841.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,822.69
|
| Rate for Payer: Healthscope Commercial |
$7,278.36
|
| Rate for Payer: Healthscope Whirlpool |
$7,060.01
|
| Rate for Payer: Mclaren Commercial |
$6,550.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,186.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,094.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,404.96
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
OP
|
$7,278.36
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$7,278.36 |
| Rate for Payer: Aetna Commercial |
$6,550.52
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$7,060.01
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$5,642.91
|
| Rate for Payer: BCN Commercial |
$5,642.91
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$5,822.69
|
| Rate for Payer: Cash Price |
$5,822.69
|
| Rate for Payer: Cofinity Commercial |
$6,841.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,822.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$7,278.36
|
| Rate for Payer: Healthscope Whirlpool |
$7,060.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$6,550.52
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,186.61
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,094.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.00
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$125.60
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,404.96
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC PROCALCITONIN
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.40 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: ASR ASR |
$98.94
|
| Rate for Payer: BCBS Trust/PPO |
$79.08
|
| Rate for Payer: BCN Commercial |
$79.08
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$95.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$102.00
|
| Rate for Payer: Healthscope Whirlpool |
$98.94
|
| Rate for Payer: Mclaren Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.76
|
|
|
HC PROCALCITONIN
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.89 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$91.80
|
| Rate for Payer: Aetna Medicare |
$27.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.02
|
| Rate for Payer: ASR ASR |
$98.94
|
| Rate for Payer: BCBS Complete |
$15.64
|
| Rate for Payer: BCBS MAPPO |
$27.22
|
| Rate for Payer: BCBS Trust/PPO |
$79.08
|
| Rate for Payer: BCN Commercial |
$79.08
|
| Rate for Payer: BCN Medicare Advantage |
$27.22
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$95.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.22
|
| Rate for Payer: Healthscope Commercial |
$102.00
|
| Rate for Payer: Healthscope Whirlpool |
$98.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$27.22
|
| Rate for Payer: Mclaren Commercial |
$91.80
|
| Rate for Payer: Mclaren Medicaid |
$14.89
|
| Rate for Payer: Mclaren Medicare |
$27.22
|
| Rate for Payer: Meridian Medicaid |
$15.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PACE Medicare |
$25.86
|
| Rate for Payer: PACE SWMI |
$27.22
|
| Rate for Payer: PHP Commercial |
$29.94
|
| Rate for Payer: PHP Medicaid |
$14.89
|
| Rate for Payer: PHP Medicare Advantage |
$27.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.82
|
| Rate for Payer: Priority Health Medicare |
$27.22
|
| Rate for Payer: Priority Health Narrow Network |
$72.42
|
| Rate for Payer: Railroad Medicare Medicare |
$27.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.76
|
| Rate for Payer: UHC Medicare Advantage |
$28.04
|
| Rate for Payer: VA VA |
$27.22
|
|
|
HC PROCESS FEE
|
Facility
|
IP
|
$36.00
|
|
| Hospital Charge Code |
30000106
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Aetna Commercial |
$32.40
|
| Rate for Payer: ASR ASR |
$34.92
|
| Rate for Payer: BCBS Trust/PPO |
$27.91
|
| Rate for Payer: BCN Commercial |
$27.91
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$33.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.80
|
| Rate for Payer: Healthscope Commercial |
$36.00
|
| Rate for Payer: Healthscope Whirlpool |
$34.92
|
| Rate for Payer: Mclaren Commercial |
$32.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.68
|
|
